Friday 1 July sees Integrated Care Systems take over from Clinical Commissioning Groups – one of the most significant changes in NHS procurement for many years.

The change will see 42 new ICSs established across England who will provide collaborative healthcare within their designated area. The new ICS model sees health and care services joined up across regions, with local authorities working together with healthcare providers, GP teams, hospitals, and other partners to improve services and deliver better outcomes for people who live and work in their area.

The journey

The journey to deliver joined up health care service has been several years in the making, with the NHS setting out its vision for the future in 2014. Partners began working to bring Integrated Care Systems to fruition in 2016, with the first models emerging in 2018 and NHS England working closely with them to pioneer best practice.

The Purpose

The purpose of ICSs is to bring partner organisations together to:

• improve outcomes in population health and healthcare
• tackle inequalities in outcomes, experience and access
• enhance productivity and value for money
• help the NHS support broader social and economic development.

New initiatives

Boosting health checks in the community to find people with health problems before they become seriously unwell is a key goal of the shift to integrated care systems.

New initiatives being implemented through the systems include a GP practice in Stockport which is going into betting shops to deliver blood pressure checks, identifying and preventing hypertension issues before people end up in hospital.

In Coventry and North Warwickshire, a local sports club offers diabetes and weight management support, taking referrals from GP teams but also reaching out to people in the local area they think might be most at-risk. People can receive tailored one to one diet and lifestyle support, and access to the club’s gym facilities.

And thanks to these local authority partnerships in Bedfordshire, patients who frequently call 999 but do not need emergency help are given alternative “lifesaving” support in their community, ensuring peoples’ needs are met as well as freeing up staff time to deal with emergency calls.

Saving lives and reducing costs

The changes are set to save an estimated £14M each year by reducing the number of chief executives working in the NHS by almost 170.

New systems are already proving to be an effective tool in tackling the covid backlogs, with eight systems reducing two-year waiters to single figures ahead of the end of July target. Nationally, there are 70% fewer two-year waiters than in January.

Amanda Pritchard, NHS chief executive, said: “Integrated care systems have the power to truly transform the way that we care for people up and down the country – not only will the NHS provide care when someone is unwell or has an accident but alongside our local government partners, we must also now play an increasing key role in managing peoples’ health so that we can catch more killer conditions earlier and save lives.

“Local areas are already doing this by going out into communities to spot signs and symptoms earlier in places such as sports clubs and betting shops as well as ensuring people can access community support rather than using 999 or going to A&E.

“Through these schemes, we are already making a massive difference to peoples’ lives. The NHS will now build on this success and innovation and deliver care for patients that is fit for the future as well as saving taxpayers’ millions of pounds each year”.

What does this mean for you and how HCI can help

The HCI research team have been busy updating our extensive NHS contacts database with details of the 42 new ICS organisations and the staff who will be working within them.

Our research is meticulous – after all, this is much more than a public sector re-branding exercise. New organisations, new roles, new responsibilities and new routes to engagement – it’s a major change that any business supplying to the NHS needs to be across.

We’ll be publishing transition updates on the HCI website and will provide further insights into the changes and what they mean for the NHS supply chain.

Interested in finding out more about what HCI can do for you?

Book a demonstration today and explore the world of opportunity in regard to healthcare tendering.

Just a week before the World Health Organization labelled COVID-19 a “public health emergency of international concern” a panel had sat down to discuss the ways in which the NHS could carve out a greener future in line with global attempts to achieve net zero carbon emissions.

Regardless of the global pandemic, being able to put a timeframe on such a feat for an organisation of the size of the NHS was always going to be particularly difficult.

In How to achieve a net zero carbon NHS during a pandemic (2021) scholar Emma Wilkinson details how, despite the rapidly developing virus that so heavily impacted the healthcare service, they still committed to achieving net zero by 2040 in a decision made in October 2021, referencing the inextricable link between the climate crisis and ill health.

A united approach against climate change

During COP26 in Glasgow, it was agreed that all UK health services would commit to becoming net zero. They were joined by 47 countries globally who agreed similar ambitions. Considering that 4.6% of the world’s greenhouse gas emissions come from health systems, these commitments were significant.

When announcing the NHS’ decision to partner with the worldwide scheme supported by the COP 26 Health Programme, further reference was made to the association between driving down emissions and improving public health by Health and Social Care Secretary Sajid Javid: “The impacts of climate change represent the biggest public health challenge of this century, which could be felt around the world through greater water and food insecurity, extreme weather events and increased infectious diseases.”

Mr Javid went on to add: “As a health community, we cannot simply sit on the sidelines – we must respond to climate change through urgent action, with global collaboration at its core.”

The UK Government has pledged considerable support so far. More than £330 million was invested in climate-smart healthcare and low carbon hospitals for NHS England. The devolved administrations have also committed to supporting net zero. NHS Scotland is due to have all small and medium vehicles operating at net zero by 2025, low carbon heating is to be used across all NHS new builds in Wales, while Health and Social Care Northern Ireland will emphasise their influence on supporting the supply chain to reduce their carbon emissions. These are just some of many announcements that have been made.

That said, however, how much of this is going to be playing catch up thanks to the events of the pandemic?

In this article, we take a look at the impacts of the pandemic on the NHS’ ability to reach net zero.

Pandemic pollution galore

NHS Scotland figures released in May 2021, some 14 months into the pandemic, revealed that 1 billion items of PPE had been used. The figures, which account for items used between 1^st March 2020 and 5^th May 2021 detail 664.8m gloves, 190.9m Type IIR masks, and 187.1m aprons. The volume of PPE being used were so large that an additional £7m in NHS contracts were awarded to deal with the waste.

Findings collated by a group of researchers in the US and China and published in December 2021 detailed how the world has created approximately 8 million tonnes of pandemic plastic waste since the beginning of the pandemic, of which a significant amount has now made it to the sea. What the report by Peng, Wu, Schartup et al (2021), published in the Proceedings of the National Academy of Sciences of the United States of America, did reveal, however, was that despite the volumes of PPE and other disposable items used by European and North American nations, such as the UK & the US, which were hit hardest by the pandemic in terms of number of cases, relatively little pandemic plastic waste was created.

On the other hand, despite having had had 30% of total global cases as of August 2021, Asia was responsible for 72% of global plastic discharge.

Rizan, Reed, & Bhutta (2021) wrote in Environmental impact of personal protective equipment, published in the Journal of the Royal Society of Medicine “the carbon footprint of PPE distributed during the study period totalled 106,478 tonnes CO2e. The estimated damage to human health was 239 DALYs (disability-adjusted life years) and impact on ecosystems was 0.47 loss of local species per year.”

Disposing of waste

Perhaps one of the most challenging aspects of the pandemic and the ensuing sustainability impacts was the fact we hadn’t negotiated such an event in just over a century, and were now doing so in at a time when we both used far more disposable medical equipment and were so conscious of our environmental impact.

PPE: Polluting Planet Earth (Dean, 2020) reported that if each individual were to wear a single-use face mask every day for an entire year, more than 66,000 tonnes of unrecyclable plastic waste would be produced. Tragically, there is no system in place yet for the environmentally friendly disposal of single use face masks that are potentially contaminated – the vast majority go to landfill.

The NHS labels waste as either infectious, offensive, or municipal – used PPE usually falls under the category of infectious or offensive and must be disposed of in a way that prevents infection. This usually involves burning at an offsite incineration plant.

There is controversy surrounding the burning of waste – while on one hand, it is used to heat local buildings and provide electricity (municipal waste contributed 2% of UK energy in 2018), incineration has also been criticised for releasing harmful gases and requiring the use of materials for burning that could otherwise have been recycled.

The true impact of the pandemic on sustainability

Unsurprisingly, it’ll be some years before we can accurately quantify how the pandemic has impacted global, domestic, and the NHS’ quest for net zero. That said, there have been a number of learnings and of course, failings.

More sustainable mask options, including reusable, washable alternatives are certainly something we expect to receive considerable investment over the coming years. Similarly, it is estimated that UK manufacturing would have reduced the carbon footprint of PPE by more than 12% while reusing gowns and gloves could have contributed a further 10% reduction.

That said, however, we successfully managed to adopt digitalisation during the pandemic, which considerably reduced travel requirements within primary care – balancing in some respects the environmental failures.

There are a number of different takeaways from the impact the last two years has had on the environment but, for now, the healthcare sector can reflect, learn, and issue new healthcare contracts to suppliers who believe they can help the system reach net zero successfully. Interested in finding out more about what HCI can do for you?

Before you go, why not take a look at our blog regarding the net-zero targets within the NHS? Alternatively, book a demo today and explore the world of opportunity in regard to healthcare tendering.